Evaluation of nursing service quality in public hospitals of Dawro Zone, Southern Ethiopia

Abstract

Background: Nursing services is the diagnosis and treatment of human responses to actual or potential health problems. In Ethiopia quality of nursing services becomes deteriorating over time. In Dawro zone hospitals, 26.1% of nurses didn’t practice nursing process per the guideline. Objective: To assess the quality of nursing services in public hospitals of Dawro Zone, southern Ethiopia, 2018. Methods: Multiple case study design with mixed methods of data collection was employed from March 15-April 15/2018. Donabedian’s Structure-Process-Outcome model was used to assess the quality of the services. Its approach was formative. A total of 369 admitted clients were included by consecutive sampling technique. Moreover, 81 client-provider interactions, 81 clients’ charts, one year selected documents and 14 key informants were included. Simple and multi-variable linear regression analysis techniques were used. Qualitative data was analyzed manually and presented as triangulation with the quantitative results. The overall quality of the service was determined based on judgmental criteria. Results: Availability of program resource scored 70.4% and 53.05% in Tercha and Gessa hospital, respectively. In Gessa hospital, medication preparation room was available only in one ward, nursing standard guideline and sterilizer machine were not available on the time of evaluation, Paracentesis set and lumbar puncture set were not available for the last 3 months. Nurse to patient ratio in Tercha hospital was 1to 10. Compliance of nurses with national guideline scored 57.95% and 52.1% in Tercha and Gessa hospitals, respectively. Daily evaluation of patients condition were not practiced based on guideline for 48.3% patients in Tercha hospital, and 57.1% of patients in Gessa hospital. Twelve percent of nurses trained about nursing care practices in Gessa hospital. Only one session supervision was conducted by zonal health department for Tercha hospital. The overall patient satisfaction with nursing service was 58.85% and 63.06% in Tercha and Gessa hospital, respectively. Patient expectation on nurse’s responsiveness score, patient experience on institutional aspect score, and absence of assigned nurses for the patient have significant association with patient satisfaction. Conclusion and Recommendation: The overall level of quality of nursing service was fair in Tercha hospital and critical in Gessa hospital. Nurses should be trained, medical equipment’s need to be supplied. Moreover, regular supervision should be conducted.